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Critical care trials

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https://www.readbyqxmd.com/read/28820753/prevention-of-exposure-keratopathy-in-critically-ill-patients-a-single-center-randomized-pilot-trial-comparing-ocular-lubrication-with-bandage-contact-lenses-and-punctal-plugs
#1
Itai Bendavid, Inbal Avisar, Irena Serov Volach, Amir Sternfeld, Idit Dan Brazis, Lewaa Umar, Yiftach Yassur, Pierre Singer, Jonathan David Cohen
OBJECTIVES: To compare the effectiveness of bandage contact lenses and punctal plugs with ocular lubricants in preventing corneal damage in mechanically ventilated and sedated critically ill patients. DESIGN: Single-center, prospective, randomized, pilot study. SETTING: Sixteen-bed, general ICU at a tertiary academic medical center. PATIENTS: Adults admitted to the ICU and anticipated to require mechanical ventilation and continuous sedation for greater than or equal to 4 days...
August 17, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28820515/the-role-of-oncology-nurses-in-discussing-clinical-trials
#2
Susan A Flocke, Elizabeth Antognoli, Barbara J Daly, Brigid Jackson, Sarah E Fulton, Tasnuva M Liu, Jessica Surdam, Sharon Manne, Neal J Meropol
PURPOSE/OBJECTIVES: To describe oncology nurses' experiences discussing clinical trials with their patients, and to assess barriers to these discussions.
. RESEARCH APPROACH: A qualitative study designed to elicit narratives from oncology nurses. 
. SETTING: Community- and academic-based oncology clinics throughout the United States.
. PARTICIPANTS: 33 oncology nurses involved in direct patient care in community-based and large hospital-based settings...
September 1, 2017: Oncology Nursing Forum
https://www.readbyqxmd.com/read/28819882/novel-immunotherapies-for-multiple-myeloma
#3
REVIEW
Mattia D'Agostino, Mario Boccadoro, Eric L Smith
PURPOSE OF REVIEW: The treatment landscape of multiple myeloma is rapidly changing; however, despite improvement in patients' survival, it still remains a largely incurable disease. One hallmark of myeloma is substantial immune dysfunction leading to an increased infection rate and the inability of immune surveillance to detect neoplastic cells. Here, we critically analyze clinical approaches to harness the immune system to overcome this defect with a focus on antibody based and adoptive cellular therapies...
August 18, 2017: Current Hematologic Malignancy Reports
https://www.readbyqxmd.com/read/28819803/if-at-first-you-don-t-succeed%C3%A2-%C3%A2-adoption-of-ipad-marking-for-high-stakes-assessments
#4
Terry Judd, Anna Ryan, Eleanor Flynn, Geoff McColl
Large-scale interview and simulation-based assessments such as objective structured clinical examinations (OSCEs) and multiple mini interviews (MMIs) are logistically complex to administer, generate large volumes of assessment data, and are strong candidates for the adoption of computer-based marking systems. Adoption of new technologies can be challenging, and technical failures, which are relatively commonplace, can delay and/or create resistance to ongoing implementation.This paper reports on the adoption process of an electronic marking system for OSCEs and MMIs following an unsuccessful initial trial...
August 17, 2017: Perspectives on Medical Education
https://www.readbyqxmd.com/read/28817531/bias-confounding-and-interaction-lions-and-tigers-and-bears-oh-my
#5
Thomas R Vetter, Edward J Mascha
Epidemiologists seek to make a valid inference about the causal effect between an exposure and a disease in a specific population, using representative sample data from a specific population. Clinical researchers likewise seek to make a valid inference about the association between an intervention and outcome(s) in a specific population, based upon their randomly collected, representative sample data. Both do so by using the available data about the sample variable to make a valid estimate about its corresponding or underlying, but unknown population parameter...
September 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28817507/comparison-of-consent-models-in-a-randomized-trial-of-corticosteroids-in-pediatric-septic-shock
#6
Kusum Menon, Katharine O'Hearn, James Dayre McNally, Anand Acharya, Hector R Wong, Margaret Lawson, Tim Ramsay, Lauralyn McIntyre, Elaine Gilfoyle, Marisa Tucci, David Wensley, Ronald Gottesman, Gavin Morrison, Karen Choong
OBJECTIVES: To describe the use of deferred and prior informed consent models in the context of a low additional risk to standard of care, placebo-controlled randomized controlled trial of corticosteroids in pediatric septic shock. DESIGN: An observational substudy of consent processes in a randomized controlled trial of hydrocortisone versus placebo. SETTING: Seven tertiary level PICUs in Canada. PATIENTS: Children newborn to 17 years inclusive admitted to PICU with suspected septic shock between July 2014 and March 2016...
August 16, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28817424/impact-of-simulator-based-training-in-focused-transesophageal-echocardiography-a-randomized-controlled-trial
#7
Andreas Bloch, Robert von Arx, Reto Etter, David Berger, Heiko Kaiser, Armando Lenz, Tobias M Merz
BACKGROUND: The aim of the study was to determine if training in transesophageal echocardiography (TEE) using a TEE simulator improves the ability of novice operators to perform and interpret a focused critical care TEE. METHODS: In this prospective, randomized, controlled study with blinded outcome assessment, 44 intensive care unit trainees were randomly assigned to a control group receiving 4 hours of lecture-based training only, or an intervention group which was additionally trained for 4 hours using a TEE simulator...
August 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28815048/society-for-immunotherapy-of-cancer-consensus-statement-on-immunotherapy-for-the-treatment-of-bladder-carcinoma
#8
Ashish M Kamat, Joaquim Bellmunt, Matthew D Galsky, Badrinath R Konety, Donald L Lamm, David Langham, Cheryl T Lee, Matthew I Milowsky, Michael A O'Donnell, Peter H O'Donnell, Daniel P Petrylak, Padmanee Sharma, Eila C Skinner, Guru Sonpavde, John A Taylor, Prasanth Abraham, Jonathan E Rosenberg
The standard of care for most patients with non-muscle-invasive bladder cancer (NMIBC) is immunotherapy with intravesical Bacillus Calmette-Guérin (BCG), which activates the immune system to recognize and destroy malignant cells and has demonstrated durable clinical benefit. Urologic best-practice guidelines and consensus reports have been developed and strengthened based on data on the timing, dose, and duration of therapy from randomized clinical trials, as well as by critical evaluation of criteria for progression...
2017: Journal for Immunotherapy of Cancer
https://www.readbyqxmd.com/read/28808449/efficacy-of-enamel-matrix-derivative-in-vital-pulp-therapy-a-review-of-literature
#9
REVIEW
Shariq Najeeb, Zohaib Khurshid, Muhammad Sohail Zafar, Sana Zohaib, Fahad Siddiqui
INTRODUCTION: Vital pulp therapy (VPT) aims to preserve the health and maintain life of the tooth pulp which has been compromised by caries, trauma or restorative procedures. Recently, enamel matrix derivative (EMD) has been introduced as a material for vital pulp therapy. The aim of this review is to critically analyze and summarize the available literature on EMD for VPT. METHODS AND MATERIALS: Online databases (PubMED/MEDLINE, Google Scholar, ISI Web of Science, and Wiley-Online) were searched by using the following keywords in various combinations: Enamel Matrix Derivative, Emdogain, 'Vital Pulp Therapy, 'Apexogenisis', Apexification, Pulp Capping, Endodontics, Dentine and Pulpotomy for studies indexed from January 1949 to April 2016...
2017: Iranian Endodontic Journal
https://www.readbyqxmd.com/read/28808364/the-effect-of-furosemide-on-the-level-of-neutrophil-gelatinase-associated-lipocalin-in-critically-hospitalized-patients-with-acute-kidney-injury
#10
Hadi Hamishehkar, Sarvin Sanaie, Vahid Fattahi, Mehran Mesgari, Ata Mahmoodpoor
BACKGROUND AND AIMS: Oliguric acute kidney injury (AKI), commonly attributed to a more severe degree of renal injury, is associated with poorer prognosis than nonoliguric form. The aim of this study was to determine the effect of furosemide therapy on kidney function and on the level of neutrophil gelatinase-associated lipocalin (NGAL) in critically hospitalized patients in the Intensive Care Unit (ICU). MATERIALS AND METHODS: In this randomized controlled trial, 106 ICU patients with AKI were assigned into furosemide and control groups...
July 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28808360/bemiparin-versus-enoxaparin-in-the-prevention-of-venous-thromboembolism-among-intensive-care-unit-patients
#11
Mohamed Sayed Abbas
BACKGROUND: Critically ill patients are considered a high-risk group for developing venous thromboembolism (VTE). Due to their impaired cardiopulmonary reserve, these VTEs may result in significant morbidity and mortality. In this study, we compared two types of low molecular weight heparin, enoxaparin, and bemiparin, as regards to their efficacy and safety in VTE prevention among Intensive Care Unit (ICU) patients. METHODS: This study was a prospective, randomized trial of 100 critically ill patients who are at high risk for developing VTE were included in this study and assigned to receive subcutaneous injections of either 3500 international units (IU) anti-factor Xa of bemiparin sodium or 40 mg of enoxaparin given once a day and patient were followed for 60 days after initiation of anticoagulant therapy for the development of documented deep venous thrombosis (DVT) using bilateral lower limb venous duplex, documented pulmonary embolism using computed tomography pulmonary angiography, and complications related to injectant anticoagulant...
July 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28807071/single-rescuer-ventilation-using-a-bag-valve-mask-with-removable-external-handle-a-randomized-crossover-trial
#12
Paul Reed, Baruch Zobrist, Monica Casmaer, Steven G Schauer, Nurani Kester, Michael D April
Introduction Ventilation with a bag valve mask (BVM) is a challenging but critical skill for airway management in the prehospital setting. Hypothesis Tidal volumes received during single rescuer ventilation with a modified BVM with supplemental external handle will be higher than those delivered using a standard BVM among health care volunteers in a manikin model. METHODS: This study was a randomized crossover trial of adult health care providers performing ventilation on a manikin. Investigators randomized participants to perform single rescuer ventilation, first using either a BVM modified by addition of a supplemental external handle or a standard unmodified BVM (Spur II BVM device; Ambu; Ballerup, Denmark)...
August 15, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28807024/society-for-immunotherapy-of-cancer-consensus-statement-on-immunotherapy-for-the-treatment-of-bladder-carcinoma
#13
Ashish M Kamat, Joaquim Bellmunt, Matthew D Galsky, Badrinath R Konety, Donald L Lamm, David Langham, Cheryl T Lee, Matthew I Milowsky, Michael A O'Donnell, Peter H O'Donnell, Daniel P Petrylak, Padmanee Sharma, Eila C Skinner, Guru Sonpavde, John A Taylor, Prasanth Abraham, Jonathan E Rosenberg
The standard of care for most patients with non-muscle-invasive bladder cancer (NMIBC) is immunotherapy with intravesical Bacillus Calmette-Guérin (BCG), which activates the immune system to recognize and destroy malignant cells and has demonstrated durable clinical benefit. Urologic best-practice guidelines and consensus reports have been developed and strengthened based on data on the timing, dose, and duration of therapy from randomized clinical trials, as well as by critical evaluation of criteria for progression...
August 15, 2017: Journal for Immunotherapy of Cancer
https://www.readbyqxmd.com/read/28807019/barriers-and-facilitators-to-the-implementation-of-antenatal-syphilis-screening-and-treatment-for-the-prevention-of-congenital-syphilis-in-the-democratic-republic-of-congo-and-zambia-results-of-qualitative-formative-research
#14
Dalau Nkamba, Musaku Mwenechanya, Arlette Mavila Kilonga, Maria Luisa Cafferata, Amanda Mabel Berrueta, Agustina Mazzoni, Fernando Althabe, Ezequiel Garcia-Elorrio, Antoniette K Tshefu, Elwyn Chomba, Pierre M Buekens, Maria Belizan
BACKGROUND: The impact of untreated syphilis during pregnancy on neonatal health remains a major public health threat worldwide. Given the high prevalence of syphilis during pregnancy in Zambia and Democratic Republic of Congo (DRC), the Preventive Congenital Syphilis Trial (PCS Trial), a cluster randomized trial, was proposed to increase same-day screening and treatment of syphilis during antenatal care visits. To design an accepted and feasible intervention, we conducted a qualitative  formative research...
August 14, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28806982/software-guided-versus-nurse-directed-blood-glucose-control-in-critically-ill-patients-the-logic-2-multicenter-randomized-controlled-clinical-trial
#15
Dieter Mesotten, Jasperina Dubois, Tom Van Herpe, Roosmarijn T van Hooijdonk, Ruben Wouters, Domien Coart, Pieter Wouters, Aimé Van Assche, Guy Veraghtert, Bart De Moor, Joost Wauters, Alexander Wilmer, Marcus J Schultz, Greet Van den Berghe
BACKGROUND: Blood glucose control in the intensive care unit (ICU) has the potential to save lives. However, maintaining blood glucose concentrations within a chosen target range is difficult in clinical practice and holds risk of potentially harmful hypoglycemia. Clinically validated computer algorithms to guide insulin dosing by nurses have been advocated for better and safer blood glucose control. METHODS: We conducted an international, multicenter, randomized controlled trial involving 1550 adult, medical and surgical critically ill patients, requiring blood glucose control...
August 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28806293/-optimizing-your-post-surgical-scars-a-systematic-review-on-best-practices-in-preventative-scar-management-1
#16
Justin L Perez, Rod J Rohrich
BACKGROUND: Scar management is critical for every plastic surgeon's practice and, ultimately, the patient's satisfaction with his or her aesthetic result. Despite the critical nature of this component of routine post-operative care, there has yet to be a comprehensive analysis of the available literature over the last decade to assess the best algorithmic approach to scar care. To this end, a systematic review of best practices in preventative scar management was conducted to elucidate the highest level of evidence available on this subject to date...
August 3, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28803752/optimal-dose-timing-and-ratio-of-blood-products-in-massive-transfusion-results-from-a-systematic-review
#17
REVIEW
Zoe K McQuilten, Gemma Crighton, Susan Brunskill, Jessica K Morison, Tania H Richter, Neil Waters, Michael F Murphy, Erica M Wood
Optimal dose, timing and ratio to red blood cells (RBC) of blood component therapy (fresh frozen plasma [FFP], platelets, cryoprecipitate or fibrinogen concentrate) to reduce morbidity and mortality in critically bleeding patients requiring massive transfusion is unknown. We performed a systematic review for randomized controlled trials (RCT) in MEDLINE, The Cochrane Library, Embase, CINAHL, PubMed the Transfusion Evidence Library and using multiple clinical trials registries to 21 February 2017. Sixteen RCTs were identified: six completed (five in adult trauma patients, one pediatric burn patients) and ten ongoing trials...
July 6, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28802288/efficacy-and-safety-of-pectin-supplemented-enteral-nutrition-in-intensive-care-a-randomized-controlled-trial
#18
Fengchan Xi, Xingwei Xu, Shanjun Tan, Tao Gao, Jialiang Shi, Yanxi Kong, Wenkui Yu, Jieshou Li, Ning Li
BACKGROUND AND OBJECTIVES: Enteral nutrition (EN) can improve clinical outcomes as an important treatment in critically ill patients. However, when patients suffer from gastrointestinal function disorders, intestinal intolerance occurs and EN administration may be delayed and even fails to perform. Pectin, a structural heteropolysaccharide, could protect gastrointestinal function from disorders in many gastrointestianl diseases. The present study aimed to determine whether pectin-supplemented EN was safe and improved clinical outcomes in intensive care unit (ICU) patients...
2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28801473/type-2-diabetes-in-the-real-world-the-elusive-nature-of-glycemic-control
#19
Steven V Edelman, William H Polonsky
Despite U.S. Food and Drug Administration (FDA) approval of over 40 new treatment options for type 2 diabetes since 2005, the latest data from the National Health and Nutrition Examination Survey show that the proportion of patients achieving glycated hemoglobin (HbA1c) <7.0% (<53 mmol/mol) remains around 50%, with a negligible decline between the periods 2003-2006 and 2011-2014. The Healthcare Effectiveness Data and Information Set reports even more alarming rates, with only about 40% and 30% of patients achieving HbA1c <7...
August 11, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28800059/the-impact-of-educational-interventions-on-attitudes-of-emergency-department-staff-towards-patients-with-substance-related-presentations-a-quantitative-systematic-review
#20
Miriam Gonzalez, Diana E Clarke, Asha Pereira, Krystal Boyce-Gaudreau, Celeste Waldman, Lisa Demczuk, Carol Legare
BACKGROUND: Visits to emergency departments for substance use/abuse are common worldwide. However, emergency department health care providers perceive substance-using patients as a challenging group to manage which can lead to negative attitudes. Providing education or experience-based exercises may impact positively on behaviors towards this patient population. Whether staff attitudes are similarly impacted by knowledge acquired through educational interventions remains unknown. OBJECTIVES: To synthesize available evidence on the relationship between new knowledge gained through substance use educational interventions and emergency department health care providers' attitudes towards patients with substance-related presentations...
August 2017: JBI Database of Systematic Reviews and Implementation Reports
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